Australasian Medical Journal
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Maternal Education and Childbirth Care in Uganda
Get PDFBackgroundGlobally, over 500,000 females die of complications related to pregnancy and childbirth each year, and of these, over 99% of deaths occur in developing countries such as Uganda. Utilisation of modern and professional care during delivery is important in lowering maternal mortality. This paper sets out to investigate the factors associated with the utilisation of modern and professional childbirth care so as to inform policy makers on the pertinent factors that need to be influenced by policy. Method A nationally representative Uganda Demographic and Health Survey (UDHS) (2006) was used. Sampling was done in two stages. In the first stage 321 clusters were selected from a list of clusters sampled in the 2005/06 Uganda National Household Survey (UNHS), 17 clusters from the 2002 Census frame from Karamoja, and 30 internally displaced camps (IDPs). In the second stage, the households in each cluster were selected as per the UNHS listing. In addition an additional 20 households were randomly selected in each cluster. Questionnaires were used during data collection. During the analysis, a maximum likelihood probit technique was employed. Prior to this, a bivariate approach was used to generate average percentages of mothers using the childbirth care services by background characteristics.ResultsIt is found that maternal education is the strongest predictor, especially at post-secondary level (highest marginal effect of 33% and
Determinants of Diarrhoea and Acute Respiratory Infection
Get PDFBackgroundDiarrhoea and acute respiratory infection (ARI) are leading causes of mortality and morbidity in children under the age of five in developing countries. On the African continent, pneumonia (14%) and diarrhoea (17%) cause more child deaths than Malaria (16%), HIV/AIDS (4%), and measles (1%) combined. This paper set out to investigate the factors associated with the occurrence of diarrhoea and ARI incidence for children under five years in Uganda. Method We used a nationally representative Uganda Demographic and Health Survey (UDHS) (2006). Sampling was done in two stages. In the first stage 321 clusters were selected from among a list of clusters sampled in the 2005/06 Uganda National Household Survey (UNHS), 17 clusters from the 2002 Census frame from Karamoja, and 30 internally displaced camps (IDPs). In the second stage, households in each cluster were selected as per UNHS listing. In addition 20 households were randomly selected in each cluster.Questionnaires were used during data collection. During the analysis, a maximum likelihood probit model was used in order to ascertain the probability of occurrence of diseases. ResultsOn average, 32% and 48% of children in the survey suffered from diarrhoea and ARI in the two weeks prior to the survey date. The occurrence was concentrated amongst children aged 0–24 months. Mother’s education, especially at post-secondary level, reduced the probability of diarrhoea occurrence but had no effect on ARI occurrence. First hour initiation and exclusive breastfeeding reduced the probability occurrence of both diarrhoea and ARI. Other significant factors associated with the occurrence of both diseases include: regional and location differentials, wealth status, type of dwelling, mother’s occupation, child age, and child nutritional status.ConclusionPolicy interventions should target female education, eliminate location and regional disadvantages, and educate the population to adopt breastfeeding practices recommended by the World Health Organization (WHO). The government should also ensure proper dwelling places for the population that are associated with favourable health outcomes. Other proper feeding practices together with breastfeeding (after six months), should be made known to the masses so as to reduce the number of children that are malnourished and growth retarded
The General Practice Registrar Needing Assistance
Get PDFBackgroundDoctors undertaking vocational training in general practice in Australia may require assistance, in addition to the normal training offered as part of their training programme. Issues requiring assistance may go undetected for a period of time. Delay in the identification of issues leads to delay in the provision of the assistance. The aim of this study is to determine the most common reasons registrars require extra assistance, and how these issues are identified. The findings of this study will provide direction for 21 regionally based training providers (RTPs) to develop improved tools to ensure earlier detection of registrars requiring assistance.Method This study is based on qualitative research methods, using semi-structured interviews with senior medical education staff of four regional general practice training providers in Victoria, Australia.ResultsIssues identified included language and cultural issues, applied knowledge and skills, attitude and professionalism, and health and family issues.The principal method that training providers identified issues was via the GP supervisor. This was predominantly by informal communication, rather than formal evaluation sheets. Other methods included the external clinical teaching visit and other training formative assessments. These more formalised procedures were more likely to identify issues later than desired. They were also used as a way of clarifying suspected problems. The selection process was not felt to be helpful, and the examinations provided information too late.ConclusionAn increased awareness of the potential issues leading to a registrar to require assistance enables identification and subsequent action to occur in a more timely and more useful fashion. Informal communication between practices and training programme staff should be encouraged to enable these issues to be dealt with early in training
An Intervention to Increase Seafood Consumption
No full textThere is good evidence that regular fish consumption can lead to a range of health benefits, and that there is high public awareness of this fact. In spite of this, Australians do not, on average, consume fish to recommended levels. An intervention is proposed, leveraging social media and mobile technology. This approach is justified on the basis of a precedence of similar initiatives and the calculation of a potential target group size of 2.8 million adult Australians
Teaching Pharmacology in Nepal
No full textBackgroundKIST Medical College, Lalitpur, Nepal conducts problem-based pharmacology learning during small-group practical sessions. The present study was carried out to obtain student feedback regarding the sessions and suggestions for improvement. Method The questionnaire-based study was carried out among first year medical students during July 2009. Respondents were enrolled after explaining the aims and objectives of the study and obtaining written, informed consent. Basic demographic information and student agreement with a set of 30 statements using a modified Likert-type scale was noted. ResultsSixty-four of the 75 students (86%) participated. The median total score was 107 (maximum score 150) and was higher among males, students from within the Kathmandu valley and self-financing students. The differences were not statistically significant. The suggestions for improvement were improving the physical infrastructure of the lab and providing more time for the practical exercises. ConclusionStudent opinion was favourable. The findings would be of interest to medical educators especially in developing countries
Are Australians willing to be treated by a Physician Assistant?
Get PDFBackgroundPhysician assistants (PAs) are deployed to extend the role of the general practitioner and other doctors in Canada, England, Scotland, The Netherlands, the United States and elsewhere. Because Australians have little experience with this type of provider, we undertook a study to test the willingness of patients to be treated by a PA. Method A time trade-off preference survey was administered to women naïve about PAs in Northern Queensland in 2009. Each survey described one of three scenarios of injury and asked the patient to make a decision between waiting four hours for a doctor or one hour for a PA. ResultsA total of 229 candidate patients unconditionally participated (225 met criteria). Two-thirds were between the ages of 20 & 35 years. All but two of the participants (99%) selected to be treated by the PA regardless of the scenario. When choices of time differences between a doctor and a PA were reduced to 2 hours and 1 hour, respectively, the preferential choice of seeing the PA persisted. ConclusionAustralian women in Northern Queensland were willing to be treated by a PA as a theoretical construct and without actual experience or knowledge of PAs. The familiar doctor care was traded for that of a PA when access to care was more available. Developing PAs in Australian society may be practical and patient attitudes more accepting, than realized. The concept of willingness to be treated has utility in socioeconomic research
Clinical presentation of urolithiasis in Ajman, UAE
Get PDFBackground Urolithiasis is an increasing problem in the United Arab Emirates (UAE). The mean age at onset of urolithiasis varies according to region. MethodRecords of urolithiasis cases confirmed by ultrasonography during the period 2007 to 2009 were retrieved from the Department of Medical Records. PASW 17 version was used for data analysis. ResultsOut of 458 patients 83.8% were males and 16.2% females. The male to female ratio was 5.2:1. The mean age at onset of urolithiasis was 33.1years with a SD of 8.6 years. There was no statistically significant difference in age at onset of urolithiasis among male and female. With regard to different anatomical sites, there was no statistically significant difference in age at onset. With regard to different anatomical sites, there was no statistically significant difference with age at onset, except an earlier onset seen for stone in kidney in females and for stones at multiple sites in males (
Pneumatic Tourniquet and Knee Surgery
Get PDFThe pneumatic tourniquet has been used in extremity surgery, especially in knee surgery. Both advantages and disadvantages were reported for using this co-operative instrument. The advantages, such as improving the surgical field and decreasing the blood loss were significant, however, disadvantages—such as increasing risk of deep vein thrombosis (DVT), nerve and muscle injuries—made its use controversial. In this review we evaluated the impact of the tourniquet on knee surgery, briefly focusing on its advantages and disadvantages in order to offer surgeons a more reliable guidelines. In previous studies there were several limitations in methodological design, tourniquet identifications, and post-operative anticoagulant regime, which made the results unreliable. Limitations such as not considering blinding assessors, assessing results with intention to treat principles, justification of sample size on the basis of power calculation and described cohort study were the most common problems in methodological designs. Lack of notification in assessing quality of life in tourniquet-used patients was a major problem which needs to be further evaluated. So we recommended designing a study that would preclude the aforementioned limitations